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Individual
DR. MICHAEL JENNINGS LANE SR.
Active
Individual
DR. MICHAEL JENNINGS LANE SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
041354134
IL
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
28230854A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209023083
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71011081A
IN
Other
Enumeration date
04/21/2021
Last updated
02/26/2025
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